The role of a potential biomarker in patients with migraine: review and new insights

ABSTRACT

Introduction: The search for an ideal biomarker for migraine has persisted for a long time. There is plentiful evidence of potential biomarkers for migraine found in cerebrospinal fluid, blood, and saliva.

Areas covered: Herein, the authors highlight and discuss the most promising candidates in the literature. An electronic search was performed for studies published between 2010 and 2020 in MEDLINE, PubMed, and EMBASE, related to potential biomarkers in migraine patients, found in cerebrospinal fluid, saliva, and serum, focusing on biomarkers that can be related to treatment and clinical outcomes.

Expert opinion: An ideal biomarker, or a panel of biomarkers, could revolutionize the way we address and propose treatments for this disease. Once severe presentations and phenotypes have been identified using a reliable biomarker, patients could be treated at earlier disease stages with more specific medications. The most important biomarkers with the most significant levels of evidence comprised calcitonin gene-related peptide (CGRP), glutamate, nerve growth factor, some inflammatory (CRP, TNF-α, interleukins) and oxidative stress markers. CGRP was associated with episodic, chronic migraine and response to treatment. Pituitary adenylate cyclase-activating polypeptide is an emerging neuropeptide involved in migraine diagnostics and severity. New genetic and epigenetic biomarkers will be candidates for future research.

KEYWORDS:

• Headache
• migraine
• biomarker
• calcitonin gene-related peptide
• glutamate

ARTICLE HIGHLIGHTS

• Potential biomarkers for migraine can be found in cerebrospinal fluid, blood, and saliva.

• They can be related to disease diagnosis, severity, and treatment efficacy.

• The most important biomarkers with the most significant levels of evidence comprised calcitonin gene-related peptide, glutamate, nerve growth factor, some inflammatory (CRP, TNF-α, interleukins) and oxidative stress markers.

• The authors discuss here if treatment selection can be based on biomarker levels

Declaration of statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.